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4. 

6. Please submit vacation requests below or in person at the Lino Lakes Police Department: 
   640 Town Center Parkway | Lino Lakes | MN 55014

8. Homeowner Information
10. First Name*
11. Last Name*
13. Address*
15. Cell Number*
16. Email Address*
20. Key holder to contact in case of home emergency:
22. Name*
24. Address*
26. Phone Number*
30. Additional Information
32. Do you have an alarm system?*
    -- Select One --YesNo
34. Will there be lights on inside of the residence?*
    -- Select One --YesNo
36. If YES, location of interior lights and will they be on a timer?
38. Will there be vehicles in the driveway?*
    -- Select One --YesNo
40. If YES, description of the vehicle(s):
42. Is there anyone else other than the key holder that is allowed in the residence or on the property?*
    -- Select One --YesNo
44. If YES, please add name(s):
46. Date Leaving*
    Date Leaving
47. Date Returning*
    Date Returning
Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field